A paradigm is a way of thinking, a belief system that you filter everything you think, hear, see, and read through. The filter screens out any information that doesn't fit the paradigm, so we continually reinforce what we already believe to be true or possible (whether it is or not) and discard new ideas (even when they might be life-changing).
The dominant paradigm about "weight management" today is "eat less, exercise more." I put those in quotes because they reveal the power of the paradigm. They imply that the goal of eating and exercise is to manage your weight. At the risk of being screened and discarded by your filter, let me ask you: Isn't the fundamental goal of eating to fuel and nourish your life? Isn't the fundamental goal of exercise to live to our fullest capacity? To have fun and increase your stamina, strength, flexibility, and health—rather than counteracting the food you eat?
Weight management is a result, not a reason. And it is not even a direct result at that!
The "weight management" paradigm is flawed, yet it is so pervasive that millions of people are trapped in outdated beliefs and behaviors, despite all of the evidence that it is not moving the majority toward healthier, happier, more vibrant lives. Health professionals, the media, the Internet, and friends, spouses, and parents everywhere continually feed the pipeline with biased information that supports the paradigm—not because they are malicious or ignorant, but because it is their paradigm too.
A paradigm shift finally occurs when the pain of staying the same outweighs the pain of change.
What is the pain of staying the same? Futile yo-yo dieting, deprivation, overeating, low energy, poor health, damaged self-esteem and self-confidence, and on a culture level—unfair stigmatization, mounting health care costs, decreased productivity, chronic disease, and distraction from what is truly important—healthy, happy people who are not obsessed with weight, dieting, or food.
What is the pain of change? Fear of making a mistake; admitting we were wrong; learning new beliefs, thoughts, and behaviors; making the effort to do something new; going against the tide; etc.
I believe that many individuals are finally ready to shift their paradigm. Perhaps our culture is even preparing for such a shift as the evidence mounts that what America has been doing toward the goal of "weight management" is NOT working—and it won't work in other countries that are on the same trajectory either.
If you've made it this far into this post, you may be ready for that shift. Stay tuned. It's coming.







Wow - I read this earlier today and keep coming back to it. It is interesting that it should come now. I recently was doing a 10 year plan and found I could not come up with any goals that did not revolve around my weight. Odd as I have lost around 120lbs and maintained that for around two and a half years yet what I eat, weigh, how often and hard I work out still defines my life in my mind. Surely there is more to life that this? I recently read of a woman who was recovering from anorexia who did not know what food she liked, all her decisions had been made on the basis of calorie content for so long she lost the `taste' for food. I so related to that too. Looking forward to reading more on the paradigm shift :)
Posted by: Pilbara Pink | 09/17/2009 at 01:20 AM
Dr. May,
A paradigm shift can happen only when one is willing to look from a difference perspective. A tough thing to do from within an old paradigm.
Once the pain of staying put is recognized the journey to a new paradigm can begin. With vast amount of "diet" information out there it's not a wonder that people crawl back into the safety of old thinking.
Therefore, education begins the journey rather than the shot-gun approach of trying this one, taking a stab at that one. Learn the basics, get a foundation in order to make an informed choice.
Thanks for your thought provoking piece.
RICK
Rick Lelchuk
Miami, FL, USA
Posted by: Rick Lelchuk, WMA | 09/17/2009 at 05:26 AM
Thanks so much for sharing this insight Pibara! First, let me say that Wow! to the changes you've made to lose that much weight! I can certainly understand why your focus has been on maintaining what you worked so hard to accomplish. May I ask you a question though? Why did you do it? If it was because you wanted to feel healthier and live a full life, your continued focus on food will get in the way (whether overeating or restrictive eating). You are so right! A paradigm shift will allow you to free up all your energy for accomplishing other goals that will allow you to be healthy in body, mind, heart, and spirit. As I said...stay tuned!
Posted by: Michelle May MD | 09/17/2009 at 10:55 AM
You are right Rick. Part of the problem is that the diet industry is very convincing - and the media and healthcare industry play right into it. So convincing in fact, that many people believe that THEY are the ones who have failed, not recognizing that the paradigm itself is flawed. So they try something "new" - but it is really the same old thing sliced and diced to look new (calories, exchanges, points, grams, glycemic index) - all versions of the same old paradigm. Even the basics sometimes miss the point because eating is to fuel living - not the other way around!
Posted by: Michelle May MD | 09/17/2009 at 11:02 AM
I still continue to put food and weight management in the same category only the shift that I made personally, was to look at healthy foods and look forward to how healthy they will make me feel and I look at "bad choices" and have attatched a negative to it.Once made that shift, I lost weight. Diets don't work. Anything you can so to "shift" your thinking will have a huge impact on your health, and ultimatly your weight.
Posted by: Tami Lindahl | 09/20/2009 at 11:46 AM
Thanks for your insight Michelle - you know no one has ever asked me `why' I lost weight (although many have asked how ;) ) Once again, something for me to ponder for the day. I mean, of course I love looking the way I do now and love being able to choose clothes rather than `making do' with anything that would go around me but really long term that is not enough. What happens when I get older and my body changes in ways I can't control (as I see happening in my 70-year-old mother who has severe osteoporosis and is struggling with her body image after a lifetime of being slim and active) - I need to feel good withing myself not just outside. Looking forward to more on this .......
Posted by: Pilbara Pink | 09/20/2009 at 07:18 PM
Michelle,
Reflecting on this and the concept of a paradigm shift my mind keeps focusing on a different kind of shift: plate shifts as with earthquakes. I wonder if it will take a huge impacting event, (figuratively, a very strong earthquake), to help people move away from deprivation and punishment. Or, is it going to be the slow moving small tremors that will shift our collective unconscious away from normalized disordered eating. Whatever it takes, I am right there promoting the shift too!
Julie Duffy Dillon
Dietitian & Counselor
JulieDillonRD.com
Posted by: Julie Duffy Dillon | 02/07/2010 at 05:46 PM
Excellent analogy Julie. The little tremors all of us create cannot be felt by some due to all of the distracting fist pounding and foot stomping going on in the healthcare field, the policy arena, and the diet industry supporting the status quo of "normalized disordered eating." When the shift occurs they'll be caught off guard - while the rest of us have felt it coming for a long time!
Posted by: Michelle May MD | 02/08/2010 at 07:29 PM
One thing that I think gets lost in the idea of "dieting" is that we are programmed to survive at all costs. And "diets" signal "famine" and "starvation" to a human body, even tho our conscious minds know we're not (usually) going to die from missing a meal or two.
So it's not a lack of willpower or a character flaw, but an actual physiological need that drives us to seek food when we think there isn't enough and to store up supplies in case the famine continues.
I think we also need to realize that an enormous number of people in the health care, diet and related industries stand to lose an enormous amount of money and influence should this paradigm shift take place. And they are not going to do that quietly or easily, no matter how much sense this makes. But the more we all talk about it, the more we change our thinking, the more quickly the shift will take place.
Thanks for getting out there and talking about it, Dr. May. And thanks for allowing us to join you in that conversation.
Posted by: Pamela Riesmeyer | 02/09/2010 at 06:54 AM
Pamela, you are absolutely right. Our biology, psychology, and even sociology rebel against restriction.
Although there are tons of people making money from the diet industry, I think many of them "know not what they do." I forgive them for that but hope that this "uncommon" sense will eventually help heal their paradigm blindness.
Posted by: Michelle May MD | 02/11/2010 at 08:22 PM
Thanks for a very thought provoking piece Michelle. You are so right that a paradigm shift is needed. And while there are more and more people out there who are embracing your ideas, and advocating eating like a "normal" person (whatever "normal" really means) and losing or maintaining weight by just going with what our bodies tell us, the diet industry is as pervasive as ever. I just read that Weight Watchers is coming out with yet another plan, this time redefining how they calculate points.
In all the years I had been on Weight Watchers on and off, they change the plan every year or so. Sometimes it's a few minor changes and other times it is drastic, like this one seems to be. It makes me wonder that if their plan really worked for the majority of people (and we all know that it can't or else they'd be out of business) then why do they have to keep changing it? We have to get the word out there that there are better ways to losing or maintaining weight than by counting calories, points or whatever and restricting what we eat.
I appreciate all that I have learned from you and I look forward to seeing the day (if it comes in my lifetime) that the diet industry goes bust because of you and others like you who teach that we can live peaceful lives and still lose weight.
Posted by: Shelley Haiken | 11/04/2010 at 06:03 PM
Thanks Shelley! I truly believe the shift is happening now - we certainly can't go another 40 years like this! Thanks for all you do to help spread the word. It is definitely a team process.
Posted by: Michelle May MD | 11/04/2010 at 07:11 PM